weight gain after gastric bypass

Question
I am 42 yrs old. I had gastric bypass surgery on May 1st-2008, I was 250 pounds before surgery,,after surgery I went to 159 pounds that was my lowest weight. Its ben two years and I went back up to 196 pounds. I believe something has expanded or something.What do u suggest. I will be honest I can eat anything I want now,,and I never get sick...only with ice cream. Is there anything I can do at this point I feel Like I wrecked it all. I always feel hungry just like before surgery.

Answer
Hi Lori:

First off, it's not your fault. It's very common after two years to experience some weight gain.  Also, for many, the dumping effect does go away after the first year or so.  It's also quite normal for your pouch to stretch a bit--or your stoma to get a little bigger. There are a few things you can try:

1) The 5 Day Pouch Diet has been successful with a lot of RNY folks. http://5daypouchtest.com/  Basically, this helps you get off the I can eat anything mode--and sort of resets your pouch.  Give it a try.  It's only five days.  I know it can be tough to go back to liquids for a few days, but you can tell youself if you did a revision, you'd have to anyways--and for much longer. ;)

2) Track your protein.  A lot of people find that they are less hungry if they get at least 100 grams of protein per day.  See if you can get 100 grams of protein in for the next week or so and see if it makes a difference.  Remember protein first, then go for non-starchy carbs/veggies, then fruit/starch.

3) If you've gone back to sodas, even diet, try and stick with water.  Some people say that the carbonation can stretch your pouch. I've never seen anything that substantiates that, but I have seen studies that do show that artificial sweeteners make you cave more sweets.

4) See if your surgeon has a graduates support group.  A lot of times, getting back with others who are going though the same thing can really help.

5) Consider joining Weight Watchers, Jenni Craig, or NutriSystem.  Even if you were never able to stick to a diet before, it can be a totally different experience post-surgery.  You'll get some accountability--and you really don't have that much to lose to reach goal. :)

6) IF none of these work, you can look at a revision.  There are basically two options--putting a band over your pouch or a duodenal switch.  Hang out on the revision boards of Obesity Help and ask questions.  

7) One final option would be to just celebrate losing more than 50 pounds and work on keeping that off.  You know it is unlikely you would have done it without the surgery--so the fact that you've kept off over 50 pounds for two years does make you a success.  See if you can maintain you new weight over the summer and then pehaps when the fall comes, try and lose another 5-15 pounds.  Taking things slowly, and using you tool (which really will still work), might be the best approach.

I know how tough it is to deal with regain, but please don't beat yourself up about it.  It happens to a lot of people.  I know you can find a solution.  Remember, you're still a success--you've lost over 50 pounds.  Even with the best diet drugs, you would have probably lost less than 25 pounds (10%).  

Kind Regards,
Karla

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